Cost and risk management in critical care: reducing the use of colloids

Source:
NICE Quality and Productivity Case Studies
Publisher:
City Hospitals Sunderland NHS Foundation Trust
Publication date:
06 October 2015

Abstract

n the past, colloid fluid therapy was used as the primary resuscitation fluid in critically ill people. Increasing evidence (in this case from the Cochrane Database of Systematic Reviews. See contacts and resources) suggests that crystalloid fluids are equivalent in effectiveness and cost considerably less. This project aimed to reduce colloid use by removing them from the clinical area and making them available by consultant prescription only.

After a successful pilot called ‘the colloid holiday’, colloids were removed from critical care. Exceptions were made for some patients for whom the treating physician considered them effective (generally patients with fluid- and vasoconstrictor-resistant shock). Consultant-only prescription was made mandatory for all colloid administration. Despite the exceptions, colloid use dropped dramatically.

This example is from an 18-bedded critical care unit.